GP confidence in counselling patients about COVID-19 vaccines: A cross-sectional survey.

Announcements declaring promising interim results of multiple candidate COVID-19 vaccines [[1], [2], [3]], combined with governmental authorisation for their use in mass vaccination programmes [4], bring potential hope for a return to some semblance of normality. Many patients have legitimate questions regarding the safety, efficacy and acceptability of these vaccines [5], and often consult their general practitioner (GP) to have these concerns addressed. This is driven by GPs being regarded as accessible sources of trusted vaccine information [8], and their visibility at the forefront of vaccine delivery [6].

However, the unprecedented speed of vaccine developments [7], coupled with exceptional workloads [8] and the challenges of remote consulting in primary care during the pandemic [9], may prevent GPs from staying up-to-date with the latest vaccine information. This may influence the confidence of GPs in counselling patients, answering their questions, and addressing their concerns regarding COVID-19 vaccines. Here, the key results of an online survey assessing this confidence are presented, and the implications and consequent recommendations briefly discussed.

Participants were asked to respond on a four-point Likert scale (not at all confident, slightly confident, fairly confident, very confident) to 25 statements concerning their confidence in counselling patients about COVID-19 vaccines (detailed methods in Appendix). 220 individuals participated in the survey between 14 December 2020 and 18 January 2021. All participants were GMC-registered GPs currently practicing in the UK with between 1 and 50 years of clinical experience in general practice.

The proportion of participants who reported no or only slight confidence in counselling patients about the inclusion of clinically vulnerable individuals in vaccine trials, the safety of vaccines in specific groups, and the potential for adverse effects not yet seen in vaccine trials, was 58.2%, 67.3% and 74.5%, respectively. The proportion of participants who reported no or only slight confidence in counselling patients about the meaning of reported vaccine efficacies (whether against, for example, mortality, symptomatic disease, viral transmission, etc), how these efficacies apply to specific groups (e.g. over 80 years old, co-morbidities, pregnancy, etc), and whether individuals participating in vaccine trials will be eligible to receive an approved vaccine, was 81.8%, 81.8% and 78.2%, respectively. Crucially, the proportion of participants who reported no or only slight confidence in their ability to access up-to-date, trustworthy, useable vaccine information designed for health professionals, and to signpost patients towards similar information designed for patients, was 52.7% and 54.5%, respectively. Overall, over 50% of participants reported no or only slight confidence in 17 of the 25 statements (full results in Appendix).

These findings indicate that GP confidence in counselling patients about COVID-19 vaccines is generally low. This has important implications for patients who seek the counsel of GPs to have their concerns about vaccine safety, efficacy and acceptability addressed. Inadequate, inaccurate, or unclear messaging from GPs could prevent patients from making fully-informed decisions, negatively influence their willingness to accept a vaccine, and fuel vaccine hesitancy by amplifying suspicion and mistrust [10].

A single source of reliable and regularly-updated vaccine information must be made readily available for GPs counselling patients about COVID-19 vaccines. In addition, patient-friendly resources must be created by respected public health bodies for GPs to signpost towards, which must be equitably accessible by being free-of-charge and available in multiple formats and languages. Crucially, GPs must be made aware of these resources and encouraged to utilise them when counselling patients.

Such action is urgently needed to empower GPs to provide strong, unified, transparent messaging about COVID-19 vaccines. Given their disproportionate responsibility in communicating with patients, this is of paramount importance to the vaccines’ success, and the hope for a return to some semblance of normality.

Ethics approval

N/A.

Contributorship statement

RA is responsible for the entire work.

Funding

None.

Declaration of competing interest

None declared.